In the medical arts, it is well known to provide an endotracheal tube for use in ventilation of a patient for anesthesia, critical care, resuscitation and other procedures and care requirements commonly arising. The endotracheal tube is commonly connected to an external ventilating system and is inserted through the mouth of the patient into the trachea where an inflatable cuff on the tube is inflated with air pressure to seal the trachea.
In the prior art, the endotracheal tube commonly has been secured in place by any of a variety of means including adhesive tape applied to the facial area of the patient or an endotracheal tube holder which has often included a bite block that the patient grips in his teeth. The bite block serves the purpose of allowing the patient something to bite on in normal response to the insertion and presence of the tube in the throat. The prior art tube holders have also commonly included a tube lock means for securing the endotracheal tube in place with respect to the face plate of the tube holder. Typical of the prior art endotracheal tube holders are those disclosed in U.S. Pat. Nos. 2,908,269 and 3,774,616, for example.
The prior art of endotracheal tube holders has not been without significant deficiencies. For example, during nursing care, the run of tubing external to the patient commonly must be manipulated and this creates a tendency for the tubing within the trachea or airway of the patient to move also. Considerable discomfort may result for the conscious or semi-conscious patient as tube manipulation stimulates the patient's gag reflex. In response, the patient may choke or try to remove the tube from his airway. In addition, inadvertent movement of the tube during external manipulation thereof may result in trauma to the mucous membrane lining the upper regions of the throat. An additional problem associated with some prior tube holders is that oral care must be attended to without disturbing the tube or its securing system. This has not been possible with many prior tube holder systems.
Other problems evident in the prior art include the lack of a suitable means for securing the endotracheal tube with respect to the tube holder and for securing the tube holder to the patient's head. Preferably, there should be provided a simple and fast acting means for locking the tube with respect to the tube holder in a manner that angular movement of the external run of tube will not affect the angle of entry of the tube into the patient's mouth. An additional requirement to achieve this end is that suitable means be provided for securing the tube holder with respect to the patient's head in a firm but yet comfortable manner. This latter problem is of particular significance, as the patient often will have the tube in place in his airway for extended periods of time. The use of adhesive tape as a tube securing system, or of elastic bands which exert continuous pressure on the patient's skin, both have a tendency to traumatize the patient's skin and thereby create considerable additional patient discomfort over and above that of the tube itself.